Format

Send to

Choose Destination
See comment in PubMed Commons below
Int J Chron Obstruct Pulmon Dis. 2011;6:157-69. doi: 10.2147/COPD.S16070. Epub 2011 Feb 28.

Value of procalcitonin, C-reactive protein, and neopterin in exacerbations of chronic obstructive pulmonary disease.

Author information

1
Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Fundació Institut d'Investigació en Ciències de Salut Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.

Abstract

OBJECTIVE:

The identification of biological markers in order to assess different aspects of COPD is an area of growing interest. The objective of this study was to investigate whether levels of procalcitonin (PCT), C-reactive protein (CRP), and neopterin in COPD patients could be useful in identifying the etiological origin of the exacerbation and assessing its prognosis.

METHODS:

We included 318 consecutive COPD patients: 46 in a stable phase, 217 undergoing an exacerbation, and 55 with pneumonia. A serum sample was collected from each patient at the time of being included in the study. A second sample was also collected 1 month later from 23 patients in the exacerbation group. We compared the characteristics, biomarker levels, microbiological findings, and prognosis in each patient group. PCT and CRP were measured using an immunofluorescence assay. Neopterin levels were measured using a competitive immunoassay.

RESULTS:

PCT and CRP showed significant differences among the three patient groups, being higher in patients with pneumonia, followed by patients with exacerbation (P < 0.0001). For the 23 patients with paired samples, PCT and CRP levels decreased 1 month after the exacerbation episode, while neopterin increased. Neopterin showed significantly lower levels in exacerbations with isolation of pathogenic bacteria, but no differences were found for PCT and CRP. No significant differences were found when comparing biomarker levels according to the Gram result: PCT (P = 0.191), CRP (P = 0.080), and neopterin (P = 0.109). However, median values of PCT and CRP were high for Streptococcus pneumoniae, Staphylococcus aureus, and enterobacteria. All biomarkers were higher in patients who died within 1 month after the sample collection than in patients who died later on.

CONCLUSIONS:

According to our results, biomarker levels vary depending on the clinical status. However, the identification of the etiology of infectious exacerbation by means of circulating biomarkers is encouraging, but its main disadvantage is the absence of a microbiological gold standard, to definitively demonstrate their value. High biomarker levels during an exacerbation episode correlate with the short-term prognosis, and therefore their measurement can be useful for COPD management.

KEYWORDS:

C-reactive protein; exacerbation; neopterin; procalcitonin; prognosis

PMID:
21468168
PMCID:
PMC3064422
DOI:
10.2147/COPD.S16070
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Dove Medical Press Icon for PubMed Central
    Loading ...
    Support Center